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  Sunday, 25 February 2018
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Worried Momma........ My daughter is 7.....she was peeing a purple/pink color for a week------the Nurse over the phone said it was from beet juice or beet juice coloring based on things she was eating........ a week later....still purple maroon/red..........during this time she also came down with fifths disease....again our nurse diagnosed over the son also had the flu at this time..............................I insisted on her being seen even though they thought it just needed more time to flush out-----------well it was not beet coloring but blood---they sent us directly to the ER.........they did urine sample....blood work and an ultrasound.....her blood pressure was good....still had red rash that travels from location to location. They are leaning towards gross hematura from Post Strep----but they told us she had no strep in blood work? The ER PED did not seem overly concerned .....the kidney Dr at the ER said she saw both circle cells and some squiggly cells under the microscope which she thought it looked like we were on the upswing or end of whatever is happening? But her kidneys were enlarged which she said went along with infection. Urine had both white and red cells. They had us check her blood pressure every day -----good for all days-----no salt-----and follow up with a nephorolist this week. I do not understand how she can have anything related to strep if she did not show strep in her blood work? No antibiotics were given .Should I be worried that they want her to see a specialist?

It is difficult to provide concrete medical advice for a specific case without being involved directly and without having all required investigations at my disposal. So I can try and help with some general answers.

Referring specifically to the post-strep issue. You are correct, that it would not fit to call such a presentation post-strep when no there is evidence of strep infection. Perhaps what the physician meant was "post-infectious" as more organisms than strep have been associated with with glomerulonephritis (GN). There are other examples of GN that can occur around the time of infection such as IgA nephritis - which is not directly related to the infection itself. But first, I think that you should wait to see if all the urinary findings resolve when the rest of the acute illness does. One thing that should be excluded is a urinary tract infection given that there were white cells present in the urine as well as red.

Dr. Jordan weinstein
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